Journal article
Presentation and outcomes of hepatocellular carcinoma patients at a western centre
HPB (Oxford, England), Vol.13(10), pp.712-722
Received 24 March 2011; accepted 30 May 2011
10/2011
DOI: 10.1111/j.1477-2574.2011.00362.x
PMCID: PMC3210973
PMID: 21929672
Abstract
Background: The present study examines the presentation and outcomes of hepatocellular carcinoma (HCC) at a Western centre over the last decade. Methods: Between January 2000 and September 2009, 1010 patients with HCC were evaluated at the University of Pittsburgh Medical Center (UPMC). Retrospectively, four treatment groups were classified: no treatment (NT), systemic therapy (ST), hepatic artery-based therapy (HAT) and surgical intervention (SI) including radiofrequency ablation, hepatic resection and transplantation. Kaplan-Meier analysis assessed survival between groups. Cox regression analysis identified factors predicting survival. Results: Patients evaluated were 75% male, 87% Caucasian, 84% cirrhotic, and predominantly diagnosed with hepatitis C. In all, 169 patients (16.5%) received NT, 25 (2.4%) received ST, 529 (51.6%) received HAT and 302 (29.5%) received SI. Median survival was 3.6, 5.6, 8.8, and 83.5 months with NT, ST, HAT and SI, respectively (P= 0.001). Transplantation increased from 9.5% to 14.2% after the model for end-stage liver disease (MELD) criteria granted HCC patients priority points. Survival was unaffected by bridging transplantation with HAT or SI (P= 0.111). On multivariate analysis, treatment modality was a robust predictor of survival after adjusting for age, gender, AFP, Child-Pugh classification and cirrhosis (P < 0.001, Ξ2= 460). Discussion: Most patients were not surgical candidates and received HAT alone. Surgical intervention, especially transplantation, yields the best survival. © 2011 International Hepato-Pancreato-Biliary Association.
Details
- Title: Subtitle
- Presentation and outcomes of hepatocellular carcinoma patients at a western centre
- Creators
- Krit Kitisin - Divisions of Hepatobiliary and Pancreatic Surgery, Department of SurgeryVignesh Packiam - Divisions of Hepatobiliary and Pancreatic Surgery, Department of SurgeryJennifer Steel - Divisions of Hepatobiliary and Pancreatic Surgery, Department of SurgeryAbhinav Humar - University of Pittsburgh Medical CenterT. Clark Gamblin - Medical College of WisconsinDavid A. Geller - Divisions of Hepatobiliary and Pancreatic Surgery, Department of SurgeryJ. Wallis Marsh - Divisions of Hepatobiliary and Pancreatic Surgery, Department of SurgeryAllan Tsung - Divisions of Hepatobiliary and Pancreatic Surgery, Department of Surgery
- Resource Type
- Journal article
- Publication Details
- HPB (Oxford, England), Vol.13(10), pp.712-722
- Edition
- Received 24 March 2011; accepted 30 May 2011
- Publisher
- Blackwell Publishing Ltd
- DOI
- 10.1111/j.1477-2574.2011.00362.x
- PMID
- 21929672
- PMCID
- PMC3210973
- ISSN
- 1365-182X
- eISSN
- 1477-2574
- Number of pages
- 11
- Language
- English
- Date published
- 10/2011
- Academic Unit
- Urology
- Record Identifier
- 9984320064602771
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